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General NPI Number Information
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NPI Number | 1548129067
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Entity Type | Organization
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Legal Business Name | LAKE CLARKE CHIROPRACTIC
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Dates
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Enumeration Date | 01/20/2026
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 1825 FOREST HILL BLVD STE 202
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-6062
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Country | US
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Telephone | 561-966-6171
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Fax | 352-664-2523
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Provider Business Mailing Address
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Address Line | 1825 FOREST HILL BLVD STE 202
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-6062
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Country | US
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Telephone | 561-966-6171
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Fax | 352-664-2523
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. MARILYNN WATTS BRADLEY
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Credential | DC
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Telephone | 954-683-6101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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